Healthcare Provider Details

I. General information

NPI: 1194546135
Provider Name (Legal Business Name): INJURY RELIEF CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 S WATSON RD STE 105
BUCKEYE AZ
85326-3433
US

IV. Provider business mailing address

10750 W MCDOWELL RD STE F600
AVONDALE AZ
85392-5971
US

V. Phone/Fax

Practice location:
  • Phone: 602-899-0494
  • Fax:
Mailing address:
  • Phone: 787-934-6759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE JUAN CRUZ
Title or Position: DIRECTOR
Credential: DC
Phone: 602-899-0494